My life with God and living with diabetes

Multiple Daily Injections

Tim, from Shoot Up or Put Up, asked me to write a post on my dealings with going back on multiple daily injections (MDI). Here it goes…

On July 13th, I gave up pumping with my OmniPod for the remainder of the summer. My profuse sweating, during outdoor exercise, caused the pods to fall off. I used Mastisol, but it dissolved as well. After having pods come off, sometimes one after the other, I became frustrated. As such, my endocrinologist re-prescribed Lantus for me and away I went.

Let me also begin by saying that I haven’t been back on MDI for, say, two years. Being back has had its ups and downs.

My insulin and syringe

The positives of MDI are:

– Lack of an attached device on you (This kinda freaked me out at first. I kept looking for my pod or my family would ask where my pod was so that they wouldn’t knock it off.)

– Not worrying whether or not you have to change out your pod or insertion site (But you do have to make sure you diabetes kit is ALWAYS with you.)

– More accountable with food (Okay, I admit it…I love to snack. I love Goldfish crackers like a kid likes ice cream. BUT, being back on shots means that I have to stick myself again for that snack. Thus, my body doesn’t need it.)

– Less severe hypoglycemia (For me personally, my liver kicks in when I get down to a 40 blood sugar level. For others, it doesn’t. In addition, I don’t suffer from seizures, unlike my sister who also has Type 1.)

– Bedtime Security (As long as I take my Lantus, I’m okay at bedtime. I don’t have to worry if my pump is suddenly going to die or crimp or…)

– Scar Tissue (This point – as the others – is debatable. Scar tissue can occur when pump sites on the skin are used too frequently, e.g. using the left side of the abdomen too much, and therefore the area doesn’t heal properly. Shots can do the same. Site rotation is the key. As for me, shots give me a little more flexibility.)

– Cost (Yes, cost. Whether you have insurance or not, pumping costs are higher than the ‘ol insulin bottle and syringe.)

The negatives of MDI are:

– Spontaneity (This goes back to the snacking ordeal. Let’s say you really want that snack of Goldfish crackers or that extra helping of spaghetti that you didn’t plan for. Well, you’ve got to take another shot for that. With the pump, you calculate and execute.)

– Dawn Phenomenon (In my opinion, the pump handles the DP much better than shots. To alleviate the DP, I exercise after dinner which helps a lot.)

– Consistency (With a pump, you are always receiving a consistent amount of insulin. Not so with shots where the insulin is prone to fade.)

– Evil Carbs (Not that we should be eating evil carbs, oh no, but the pump seems to handle such carbs as pizza and pasta much better than shots. Pumps have the feature of extending a bolus to cover the post-carb high.)

– And speaking of carbs, Carb Counting (With the newer pumps, carb counting and insulin ratios have never been easier. Just enter the amount of carbs, into your pump, and the pump does the calculations for you. No so with MDI.)

Okay, so there’s a rather quick-and-dirty Pros and Cons of MDI. I love both for what they offer. I also intend to return to the pump during the cooler months, which will be December here in Atlanta. Please see your doctor before you change regimens. I did.

If you’re looking for more information, here’s a good resource on HealthCentralthat compares both MDI and pumping.

Great post, Mark! The MDI v. Pumping is definitely an interesting re-adjustment. I’d been pumping for nine years straight, and went back to MDI in late March for a temp break. Helped lower my A1c by a whole percentage point, so I’ve continued it for the summer before going back to my pump. Wrote about it a few times, so feel free to check out my blog. And, good luck with your MDI Journey! See you around the Diabetes Online Community!

Great post, thanks for this. I’ve been thinking about pumps quite a bit having recently started grabbing my diabetes by the scruff of the neck again after several years’ of a less focussed approach. The shootuppers have already come across my fairly well ingrained pump-aversion (which I still have) though the frustrations of attempting to fine-tune MDI do make pumping seem attractive some days.

You are not the first person I’ve come across who has moved back to MDI – it was great to read your reasons for the switch.

I liked how you posted about the pros and cons. It really is something to look at since people are different and some may do better on the pump while others on MDI. I myself do much better on MDI (5% A1c).

I also exercise after dinner to make sure my mornings are good 🙂 If I happen not to exercise I have some dry wine or a little bit of beer before bed…it seems to work…lol (I’m not saying I recommend this…)

Anyway, why is it some people’s liver kicks in when their low and others doesn’t? I’ve always seriously wondered about this. Something to do with the amount of adrenaline produced maybe? I mean, when we’re low do we not feel like our adrenaline is pumping?